Infertility: Treatment, Procedure, Cost and Side Effects

• Abnormal production of sperm: Due to a genetic disorder, or health problems such as diabetes, HIV, mumps, chlamydia. It can also happen due to undescended testicles. The quality of sperm can also be affected by enlarged veins in testes.
• Problem with sperm delivery: There is a problem in the delivery of sperm due to the following conditions like certain genetic disorder, structural problems, blockage in testicles, or if there is any damage in the reproductive organs.
• Overexpose to specific environmental conditions: Certain environmental conditions like pesticides or other chemical radiations affect infertility in males. Smoking cigarettes, alcohol, marijuana or certain medicines like anabolic steroids, antibiotics can also cause infertility in males.

• Ovulation disorders: In this, there is an effect on the release of eggs from the ovaries. Polycystic ovary syndrome is also included in ovulation disorder. Thyroid glands such as hypothyroidism or hyperthyroidism can also affect the menstrual cycle which also causes infertility in females. Other causes include eating disorders, injury, tumor and excessive exercise.
• Abnormal Uterine: Abnormalities related to the opening of the cervix, polyps in the uterus or shape of the uterus. Most of the times there is interference of the fibroid with the implantation of a fertilized egg which causes infertility in females.
• Damage or blockage in the fallopian tube: Blockage or damage in the fallopian tube caused by the inflammation of fallopian tube can lead to pelvic inflammatory disease and endometriosis.
• Primary ovarian insufficiency: This is also called early menopause. It happens when there is a stoppage of the menstruation cycle before the age of 40 and then ovaries stop functioning. Although the main reason for this is unknown, there are multiple factors like immune system disease, genetic disorder, radiation, chemotherapy treatments, and smoking responsible for it.

• Semen Analysis: In this, doctor diagnose the specimen of semen and in some of the cases, sperm is also tested.
• Hormone testing: Blood test can be done to determine the level of male hormones and testosterone.
• Genetic testing: This test is done to check if there is any genetic effect or hereditary problem.
• Testicular biopsy: It is done to check the abnormalities which contribute to infertility.
• Another speciality testing: These speciality tests are done to evaluate sperm quality.

• Ovulating testing: In this, blood test is done to determine if a person is ovulating or not.
• Ovarian reserve testing: This test is done to determine the quality and quantity of eggs which are left for ovulation.
• Hormone testing: In this, it checks ovulatory hormones or the pituitary hormone levels that control the reproductive process.
• Hysterosalpingography: This looks for blockage or other problems which evaluates the condition of your uterus and fallopian tube.

Fertility can be tested at home mainly by two methods i.e FSH tests and ovulation predictor kits. The FSH test should be done on the third day of the menstrual cycle and its result tells us about the number of eggs that are left in the ovaries. The ovulation predictor test is usually performed on the ninth day of the menstrual cycle and it determines the exact time of ovulation, however, it is indicative of ‘PCOS’ if case ovulation does not occur.

There are unusual signs that indicate whether a woman is fertile or not. Some of them include the menstrual cycle which may be irregular i.e length of the cycle may be long or it may be short or it may be painful, absence of the cycle, pain during intercourse, unpredictable bleeding from the vagina, and most importantly, unable to get pregnant despite having unprotected sex for years.

Infertility treatment for male includes treatment for premature ejaculation, varicoceles, blockage of the ejaculation duct, retrograde ejaculation and also surgery for epididymal blockage. Medication and behavioural therapy can help a man to overcome general sexual problems like premature ejaculation and erectile dysfunction. A varicose vein in the scrotum, which can cause infertility, can be surgically removed.

In case of blockage of the ejaculatory duct, sperm can be injected into an egg in the laboratory after it has been extracted directly from the testicles. Retrograde ejaculation is treated by taking sperm directly from the bladder and later injected into eggs. The epididymis is a coil-like structure in the testicles that help to store and transport sperm. Surgery can help to remove the blockage if it gets blocked.

A woman is prescribed medications if she is suffering from ovulation disorders like clomifene, metformin, human menopausal gonadotropin, human chorionic gonadotrophin, bromocriptine and follicle-stimulating hormone.

In addition, there are some surgical procedures available for women. Fallopian tube surgery helps to repair damaged or scarred fallopian tubes and makes it easier for eggs to pass through them. Laparoscopic surgery also helps to increase fertility.

There are some methods which help in assisted conception like intrauterine insemination, In vitro fertilisation, intracytoplasmic sperm injection, donating sperm or egg, assisted hatching and surgical sperm aspiration.

Increasing fertility after 35 is not as easy but it can be achieved by doing some lifestyle changes. Some of them include the maintenance of bodyweight so as to achieve an optimal BMI, having a balanced diet from the nutrition point of view, quitting habits such as smoking and drinking, stress management, and the most importantly knowing the fertile window i.e the time period when the eggs are supposed to be released.